Investigación sobre la evaluación de la afasia (ROMA) en el contexto de la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF) de la Organización Mundial de la Salud (OMS)

Instrumentos de evaluación de la afasia: un consenso mundial de expertos; (Consensus outcome measures for aphasia.) En diciembre de 2017 y setiembre de 2018, un grupo de expertos en afasia se reunió en Londres y en Aveiro, Portugal, respectivamente para desarrollar un 'Core Set' de instrumentos de evaluación de la afasia con un doble objetivo: el enfoque de la opinión del paciente y los 5 dominios de CIF (trastorno, función, actividad, participación, bien-estar). Forma parte de la comisión de COMET (Core Outcome Measures in Effectiveness Trials: (http://www.comet-initiative.org/ ). El acuerdo viene después de más de tres años de investigación (Wallace et al., 2016) en la cual se reúnen las opiniones de las personas con afasia y sus familiares, los clínicos y los expertos en investigación. Este consenso permite recoger a nivel internacional las mismas medidas que contribuirán elaborar a datos a gran escala (big data) para poder contestar a las cuestiones más relevantes en afasia: ¿Cuál será el camino de recuperación? ¿Cómo llegar a la recuperación máxima? ¿Cuánto tiempo tardará?Facultad de Psicología y Logopedia de la Universidad de Málaga Unidad de Neurología Cognitiva y Afasia (UNCA, CIMES), Universidad de Málag

Exploring the perspectives of people who use Alternative and Augmentative Communication Aids (AAC)

This paper outlines the clinical doctoral research plan (funded by HEE/NIHR Integrated Clinical Academic Programme) to engage the wide range of people who use alternative and augmentative communication (AAC) to understand the perspectives of users in order to develop a Patient Reported Outcome Measure (PROM) to evaluate equipment and services

An explorative study on robotics for supporting children with Autism Spectrum Disorder during clinical procedures

This short report presents a small-scale explorative study about children with Autism Spectrum Disorder (ASD) interaction with robots during clinical interactions. This is part of an ongoing project, which aims at defining a robotic service for supporting children with developmental disabilities and increase the efficiency of routine procedures that may create distress, e.g.having blood taken or an orthopaedic plaster cast applied. Five children with confirmed diagnoses of ASD interacted with two social robots: the small humanoid NAO and the pet-like MiRo. The encounters mixed play activities with a simulated clinical procedure. We included parents/carers in the interaction to ensure the child was comfortable and at ease. The results of video analysis and parents' feedback confirm possible benefits of the physical presence of robots to reduce children’s anxiety and increase compliance with instructions. Parents/carers convincingly support the introduction of robots in hospital procedures to their help children

Sources of phoneme errors in repetition: perseverative, neologistic and lesion patterns in jargon aphasia

This study examined patterns of neologistic and perseverative errors during word repetition in fluent Jargon aphasia. The principal hypotheses accounting for Jargon production indicate that poor activation of a target stimulus leads to weakly activated target phoneme segments, which are outcompeted at the phonological encoding level. Voxel-lesion symptom mapping studies of word repetition errors suggest a breakdown in the translation from auditory-phonological analysis to motor activation. Behavioural analyses of repetition data were used to analyse the target relatedness (Phonological Overlap Index: POI) of neologistic errors and patterns of perseveration in 25 individuals with Jargon aphasia. Lesion-symptom analyses explored the relationship between neurological damage and jargon repetition in a group of 38 aphasia participants. Behavioural results showed that neologisms produced by 23 jargon individuals contained greater degrees of target lexico-phonological information than predicted by chance and that neologistic and perseverative production were closely associated. A significant relationship between jargon production and lesions to temporoparietal regions was identified. Region of interest regression analyses suggested that damage the posterior superior temporal gyrus and superior temporal sulcus in combination was best predictive of a Jargon aphasia profile. Taken together these results suggest that poor phonological encoding secondary to impairment in sensory-motor integration alongside impairments in self-monitoring result in jargon repetition. Insights for clinical management and future directions are discussed

Supporting communication in semantic dementia: Clinical consensus from expert practitioners

© Kindell, J. Sage, K. and Cruice, M. Published by Emerald Group Publishing Limited. Purpose - The purpose of this paper is to gain consensus regarding the clinical priorities and tasks required in supporting communication needs in those living with semantic dementia and their families, by specialist speech and language therapists (SLTs), working in clinical practice within dementia care settings in the UK. Design/methodology/approach - A nominal group technique was used, followed by further exploration and refinement of issues using a modified Delphi technique with a group of six SLTs who specialised in dementia care and who had experience of working with individuals with semantic dementia and their families. Findings - The findings in the study demonstrate a broader scope of practice than is evident within the research literature with this client group. Therapists identified a range of psychosocial issues for both the person with semantic dementia and their family, in particular finding ways to support activity and participation in conversation and explore barriers and facilitators within the communication environment. Originality/value - This represents the first study to explore everyday practice in this rarer dementia and the information gathered here will be of use to a variety of health and social care professions interested in supporting those with semantic dementia and their families

Everyday conversation in dementia: a review of the literature to inform research and practice

Background: There has been increasing interest in dementia care in recent years, including how practitioners, service providers and society in general can help individuals to live well with the condition. An important aspect to this is provision of advice to ensure conversation partners effectively support the person with dementia in conversation. Aims: To provide a descriptive review of the literature examining everyday conversation in dementia in order to inform practice and research. Methods & Procedures: This review used a method specifically developed for reviewing conversation analytic and related literature. A range of databases were searched using key words and explicitly described inclusion criteria leading to a final corpus of 50 titles. Using this qualitative methodology, each paper was examined and data extracted. The contribution of each of these is described and the implications for practice and research are outlined. Main Contribution: This review examined studies into conversation in Alzheimer's disease, vascular dementia and Lewy body dementia, grouping these into: early influential studies; work drawing on positioning theory; studies using social and linguistic approaches; collaborative storytelling; formulaic language; studies specifically using conversation analysis; and conversation as a target for individualized therapy. In addition, more recent work examining primary progressive aphasia and behavioural variant frontotemporal dementia was explored. Overall, this review indicates that research examining conversation in natural settings provides a rich source of data to explore not just the challenges within conversation for those taking part, but also the skills retained by the person with dementia. An important aspect of this understanding is the notion that these skills relate not only to information exchange but also aspects of social interaction. The role of others in scaffolding the conversation abilities of the person with dementia and the potential of this for developing interventions are discussed. Conclusions & Implications: The review indicates that interventions targeting conversation in dementia are often advocated in the literature but currently such approaches remain to be systematically evaluated. In addition, many of the important insights arising from these studies have yet to inform multidisciplinary dementia care practice

Therapeutic alliances in stroke rehabilitation: a meta-ethnography

OBJECTIVE: To synthesize qualitative studies exploring patients' and professionals' perspectives and experiences of developing and maintaining therapeutic alliances in stroke rehabilitation. DATA SOURCES: A systematic literature search was conducted using the following electronic databases: PsycINFO, CINAHL, Embase, MEDLINE, Allied and Complementary Medicine Database, Applied Social Sciences Index and Abstracts, and ComDisDome from inception to May 2014. This was supplemented by hand searching, reference tracking, generic web searching, and e-mail contact with experts. STUDY SELECTION: Qualitative peer reviewed articles reporting experiences or perceptions of the patient or professional in relation to therapeutic alliance construction and maintenance in stroke rehabilitation were selected for inclusion. After a process of exclusion, 17 publications were included in the synthesis. DATA EXTRACTION: All text identified in the results and discussion sections of the selected studies were extracted verbatim for analysis in a qualitative software program. Studies were critically appraised independently by 2 reviewers. DATA SYNTHESIS: Articles were synthesized using a technique of meta-ethnography. Four overarching themes emerged from the process of reciprocal translation: (1) the professional-patient relationship: degree of connectedness; (2) asymmetrical contributions; (3) the process of collaboration: finding the middle ground; and (4) system drivers. CONCLUSIONS: The findings from the meta-ethnography suggest that the balance of power between the patient and professional is asymmetrically distributed in the construction of the alliance. However, given that none of the studies included in the review addressed therapeutic alliance as a primary research area, further research is required to develop a conceptual framework relevant to stroke rehabilitation, in order to determine how this construct contributes to treatment efficacy